Endovascular Prosthesis for Ascending Aorta

Abstract

An endoluminal prosthesis for treating a diseased portion of the ascending aorta includes a tubular graft material having an outer surface and an inner surface and a support structure coupled to the graft material. An anchoring device is coupled to the proximal end of the support structure to engage the sinotubular junction or the sinuses adjacent the sinotubular junction. The anchoring device may be a stent ring with barbs on an outer surface to engage the sinotubular junction, a plurality of anchors extending into the sinuses including hooks to engage the sinuses, a plurality of bent stents with distally facing shoulders extending into the sinuses and engaging a distal edge of the sinuses, or a series of progressively larger diameter stent rings extending into the sinuses to engage the distal edge of the sinuses.

1 . An endoluminal prosthesis comprising:
 a tubular graft material having an outer surface and an inner surface, wherein the outer surface defines a first diameter;   a support structure coupled to the graft material; and   a plurality of anchors, each anchor having a distal end coupled to a proximal end of the support structure, a proximal end opposite the distal end, and a hook extending outwardly from the proximal end, wherein the anchors extend outwardly such that a second diameter defined by the proximal ends of the anchors is larger than the first diameter.   
   
   
       2 . The prosthesis of  claim 1 , wherein the prosthesis includes three anchors. 
   
   
       3 . The prosthesis of  claim 1 , wherein the prosthesis includes two anchors. 
   
   
       4 . An endoluminal prosthesis comprising:
 a tubular graft material having an outer surface and an inner surface, wherein the outer surface defines a first diameter;   a support structure coupled to the graft material; and   a stent ring coupled to a proximal end of the support structure, wherein an outer surface of the stent ring defines a second diameter that is larger than the first diameter, and wherein a plurality of barbs or hooks are coupled to the outer surface of the stent ring.   
   
   
       5 . The endoluminal prosthesis of  claim 4 , wherein the second diameter is 1.05 to 1.1 times larger than the first diameter. 
   
   
       6 . An endoluminal prosthesis comprising:
 a tubular graft material having an outer surface and an inner surface, wherein the outer surface defines a first diameter;   a support structure coupled to the graft material; and   a plurality of stent rings coupled to a proximal end of the support structure, wherein a first stent ring coupled to the support structure has a second diameter that is larger than the first diameter, and wherein each stent ring proximal of the first stent ring has a diameter equal to or larger than the stent ring distally adjacent thereto.   
   
   
       7 . The endoluminal prosthesis of  claim 6 , wherein the plurality of stent rings includes two stent rings. 
   
   
       8 . The endoluminal prosthesis of  claim 7 , wherein the plurality of stent rings includes four stent rings. 
   
   
       9 . An endoluminal prosthesis comprising:
 a tubular graft material having an outer surface and an inner surface, wherein the outer surface defines a first diameter;   a support structure coupled to the graft material; and   a plurality of angled stents extending longitudinally from and coupled to a proximal end of the support structure, wherein each stent includes a distally facing shoulder, wherein a second diameter defined by an outer edge of each shoulder is larger than the first diameter.   
   
   
       10 . The endoluminal of  claim 9 , wherein the plurality of angled stents includes two stents. 
   
   
       11 . The endoluminal prosthesis of  claim 9 , wherein the plurality of angled stents includes four stents. 
   
   
       12 . A method for treating a diseased portion of the ascending aorta comprising the steps of:
 delivering a prosthesis to the ascending aorta, wherein the prosthesis includes a graft and a stent ring coupled to a proximal end of the graft, wherein the stent ring includes an outer surface having a plurality of barbs disposed thereon;   aligning the prosthesis such that the stent ring is disposed adjacent the sinotubular junction between the aortic sinuses and the ascending aorta;   deploying the prosthesis such that the barbs on the stent ring engage the sinotubular junction.   
   
   
       13 . The method of  claim 12 , wherein the graft includes a tubular graft material having an outer surface and an inner surface and a support structure coupled to the graft material, wherein the stent ring is coupled to a proximal end of the support structure. 
   
   
       14 . The method of  claim 13 , wherein the step of deploying the prosthesis further includes the expanding the support structure and the graft material to contact an inner surface of the ascending aorta. 
   
   
       15 . The method of  claim 12 , wherein the diseased portion of the ascending aorta includes a dissection. 
   
   
       16 . The method of  claim 12 , wherein the diseased portion of the ascending aorta includes an aneurysm. 
   
   
       17 . A method for treating a diseased portion of the ascending aorta comprising the steps of:
 delivering a prosthesis to the ascending aorta, wherein the prosthesis includes a graft and a plurality of anchors coupled to and extending proximally from a proximal end of the graft, and wherein a proximal end of each anchor includes a hook extending outwardly;   aligning the prosthesis such that a proximal end of the graft is disposed adjacent the sinotubular junction and the plurality of anchors extend into the region of the aortic sinuses;   deploying the prosthesis such that the anchors expand outwardly such that the hooks engage tissue of the sinuses.   
   
   
       18 . The method of  claim 17 , wherein the step of deploying the prosthesis further includes the step of moving the prosthesis distally after the anchors have expanded outwardly such that the hooks engage tissue of the sinuses. 
   
   
       19 . The method of  claim 17 , wherein the graft includes a tubular graft material having an outer surface and an inner surface and a support structure coupled to the graft material, wherein the anchors are coupled to a proximal end of the support structure. 
   
   
       20 . The method of  claim 19 , wherein the step of deploying the prosthesis further includes expanding the support structure and the graft material to contact an inner surface of the ascending aorta. 
   
   
       21 . The method of  claim 17 , wherein the diseased portion of the ascending aorta includes a dissection. 
   
   
       22 . The method of  claim 17 , wherein the diseased portion of the ascending aorta includes an aneurysm. 
   
   
       23 . A method for treating a diseased portion of the ascending aorta comprising the steps of:
 delivering a prosthesis to the ascending aorta, wherein the prosthesis includes a graft and a plurality of anchors coupled to and extending proximally from a proximal end of the graft, and wherein a distal portion of each anchor is bent such that the anchor includes a distally facing shoulder;   aligning the prosthesis such that a proximal end of the graft is disposed adjacent the sinotubular junction and the plurality of anchors extend into the region of the aortic sinuses;   deploying the prosthesis such that the anchors expand outwardly such that distally facing shoulders of the anchors engage the distal edge of the sinuses.   
   
   
       24 . The method of  claim 23 , wherein the step of deploying the prosthesis further includes the step of moving the prosthesis distally after the anchors have expanded outwardly such that the distally facing shoulders engage the distal edge of the sinuses. 
   
   
       25 . The method of  claim 23 , wherein the graft includes a tubular graft material having an outer surface and an inner surface and a support structure coupled to the graft material, wherein the anchors are coupled to a proximal end of the support structure. 
   
   
       26 . The method of  claim 25 , wherein the step of deploying the prosthesis further includes expanding the support structure and the graft material to contact an inner surface of the ascending aorta. 
   
   
       27 . The method of  claim 23 , wherein the diseased portion of the ascending aorta includes a dissection. 
   
   
       28 . The method of  claim 23 , wherein the diseased portion of the ascending aorta includes an aneurysm. 
   
   
       29 . A method for treating a diseased portion of the ascending aorta comprising the steps of:
 delivering a prosthesis to the ascending aorta, wherein the prosthesis includes a graft and a plurality of stent rings coupled to a proximal end of the graft, wherein each stent ring has a diameter larger than the diameter of the stent ring distally adjacent thereto;   aligning the prosthesis such that a proximal end of the graft is disposed adjacent the sinotubular junction and the plurality of stent rings extend into the region of the aortic sinuses;   deploying the prosthesis such that the stent rings anchors expand outwardly and engage the distal edge of the sinuses.   
   
   
       30 . The method of  claim 29 , wherein the step of deploying the prosthesis further includes the step of moving the prosthesis distally after the stent rings have expanded have expanded outwardly such that the stent rings engage the distal edge of the sinuses. 
   
   
       31 . The method of  claim 29 , wherein the graft includes a tubular graft material having an outer surface and an inner surface and a support structure coupled to the graft material, wherein the distal most stent ring is coupled to a proximal end of the support structure. 
   
   
       32 . The method of  claim 31 , wherein the step of deploying the prosthesis further includes expanding the support structure and the graft material to contact an inner surface of the ascending aorta. 
   
   
       33 . The method of  claim 29 , wherein the diseased portion of the ascending aorta includes a dissection. 
   
   
       34 . The method of  claim 29 , wherein the diseased portion of the ascending aorta includes an aneurysm.